Systematic review of the relationship between burn-out and spiritual health in doctors

OBJECTIVE: To investigate the relationship between burn-out and spiritual health among medical doctors. DESIGN: Systematic literature review and narrative synthesis of cross-sectional studies. SETTING: Any setting, worldwide. DATA SOURCES: Five databases were searched from inception to March 2022, including Medline, Embase, PsycINFO, Scopus and Web of Science. ELIGIBILITY CRITERIA: Any study design that involved medical doctors (and other healthcare staff if assessed alongside medical doctors), that measured (in any way) both burn-out (or similar) and spiritual health (or similar) medical doctors. DATA EXTRACTION AND SYNTHESIS: All records were double screened. Data extraction was performed by one reviewer and a proportion (10%) checked by a second reviewer. Quality was assessed using the Appraisal of Cross-sectional Studies tool. Due to the heterogeneity of the included studies, a narrative review was undertaken without a meta-analysis. RESULTS: Searches yielded 1049 studies. 40 studies met eligibility criteria and were included in this review. Low reported levels of spirituality were associated with high burn-out scores and vice versa. Religion was not significantly associated with lower levels of burn-out. Few studies reported statistically significant findings, few used validated spiritual scores and most were vulnerable to sampling bias. CONCLUSIONS: Published research suggests that burn-out is linked to spiritual health in medical doctors but not to religion. Robust research is needed to confirm these findings and develop effective interventions. PROSPERO REGISTRATION NUMBER: CRD42020200145.